Provider Demographics
NPI:1699369694
Name:SANSPREE, DIXIE PURDY
Entity Type:Individual
Prefix:
First Name:DIXIE
Middle Name:PURDY
Last Name:SANSPREE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIXIE
Other - Middle Name:
Other - Last Name:PURDY-SANSPREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6012 ALLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-2512
Mailing Address - Country:US
Mailing Address - Phone:336-655-0094
Mailing Address - Fax:
Practice Address - Street 1:3111 MAPLEWOOD AVE STE 105
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3992
Practice Address - Country:US
Practice Address - Phone:336-659-8817
Practice Address - Fax:336-659-7799
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0013461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical